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Psychiatric Report
The Psychiatric Report is the thirtieth and final clue in the Mystery Man Clueline. It can be found by Sam in the lodge's basement, in Chapter 7 of Until Dawn. Overview A comprehensive report on Josh, elaborating on all his previous experiences with psychiatric treatment and medication. Transcript Cover Page OCEAN VIEW HOSPITAL HEALTH AND HAPPINESS JOSHUA WASHINGTON FINAL PSYCHIATRIC EVALUATION 05/21/2014 DR. A. HILL CONFIDENTIAL Physician History 06/11/2006 Jeremy Harris, MD Whale Point Surgery Referred on 04/02/2007 after incident at school 04/26/2007 Oliver Purkiss, MD, MPH Pastoral Wellbeing Center Referred on 10/19/2009 after incident at school 10/23/2009 Roisi Williams, MD Santa Buena Medical Center Referred on 12/09/2008 after disagreement over treatment 01/03/2010 Sarah North, MD, PhD Cranleigh Hospital Referred on 11/29/2013 after patient's response to drugs tapered badly 12/19/2013 - Present Alan Hill, MD, MPH South-Western Psychiatry Referred on 03/14/2014 due to potential suicide risk History of Prescribed Antidepressants Fluoxetine (06/18/2006 - 01/24/2010) Patient reported that side-effects (headaches, nausea) were becoming too severe, and wanted to change drug. Duloxetine (02/13/2010 - 11/01/2013) Patient claimed that the drug was no longer having any effect. Reported that his mood had badly worsened. Amitriptyline (11/29/2013 - 04/05/2014) Patient began self-medicating, taking stronger doses. Phenelzine (04/15/2014 - present) 30mg dose. Twice daily, increasing to three times daily after 2 weeks. If the patient reports any of the following symptoms, please contact a physician IMMEDIATELY. Side effects: hypotension, blurred vision, dizziness, insomnia, vomiting, diarrhea, muscle tremors, liver damage (hepatitis), On withdrawal: nausea, insomnia, nightmares, agitation, hallucinations, paranoia, aggressiveness, slurred speech, ataxia, catatonia, shocks Summary of Treatment Patient arrived delirious/confused. Strong symptoms of major depressive disorder, related to death/disappearance of sisters. Placed patient under observation. ECT was considered, given patient's history of tapering drug effects, but rejected. CBT, IPT, psychoanalysis, etc, failed to produce any improvement. New course of drugs was necessary. Patient moved onto a non-selective MAOI. Rationale being that SSRIs and SNRIs have proven ineffective in the past. Phenelzine 60mg initially. Higher than average dose was necessary to see reduction of symptoms. After 2 weeks, patient's symptoms and mood were greatly improved. Discharged on 16th May after final consultation proved satisfactory. Dr. Alan Hill Invoice OCEAN VIEW HOSPITAL DATE: 05/16/2014 INVOICE #5132 1 Pinnacle Drive Pacific Road CA 90187 SHIP TO Washington Pictures Incorporated Valley Town Burbank CA 90321 TOTAL: 26250.24 PAYMENTS/CREDITS: 0.00 BALANCE DUE: $26250.24 Location After entering the Psycho's workshop, walk to the desk on your right side and open up the drawer. Trivia * This clue can only be found by Sam if she escaped from the Psycho in Chapter 5. * Hannah's Diary states Josh went to a hospital. * This clue foreshadows the diminishing sanity of Josh, as he starts suffering the same drug withdrawal effects mentioned in the Journal later in the game. * The drugs that were prescribed to Josh are all focused around serotonin, a kind of neurotransmitter. Depression can be triggered, if there is a decrease of production of serotonin. ** Fluoxetine is a SSRI which stands for "selective serotonin re-uptake inhibitor", and this can help increase serotonin in the brain. ** Duloxetine is a selective serotonin/norepinephrine re-uptake inhibitor. ** Amitriptyline and Phenelzine are the earliest anti-depressants developed. * The drugs that he took were effective, but for his depression only, and never was effective for his suspected second mental illness, Schizophrenia. ** His main issue was suspected to be Schizophrenia, and thus was never treated: he was treated for the wrong disorder, called Major Depressive Disorder. category:Clues category:Mystery Man Clues Category:Documents Category:Clues Found by Sam